Charcoal for the management of pruritus and uremic toxins in patients with chronic kidney disease

Purpose of review: Pruritus is an important, prevalent but often neglected symptom in patients with advanced chronic kidney disease (CKD) or on dialysis. This review addresses the use of activated charcoal and its analogs in the treatment of uremic pruritus, which can be a sign of uremic toxicity. Recent findings: When common causes are corrected and dialysis efficiency is optimized, pruritus is mainly ascribed to the retention of middle and protein-bound molecules, of which indoxyl sulfate and p-cresyl sulfate are the best studied. While hemodialysis and hemodiafiltration are of limited use, activated charcoal and its analogs offer interesting alternatives. Oral preparations are associated with symptom improvement and a better metabolic pattern, probably via a combination of absorption and modification of the intestinal microbiota. Large studies, in well phenotyped populations, are needed. Hemoperfusion, commonly used in poisoning and intoxication, could be an interesting alternative in hemodialysis patients. The treatment has proved promising in some preliminary and small studies; more research is now needed to test its validity. Summary: Oral activated charcoal and hemoperfusion can be proposed to patients with severe refractory pruritus based on positive, albeit scattered evidence. They also contribute to reducing uremic toxins. Research on their implementation associated with well established treatments is needed to understand whether they can be used as 'uremic detoxifiers'

Patients' wishes, pregnancy and vascular access: When one size does not fit all

Pregnancy in dialysis patients is a rare but important event that challenges our knowledge and demands re-thinking many aspects of our practice, including vascular access. This editorial briefly discusses some open questions on vascular access in this situation that challenge the motto ‘fistula first’ and underline the need for personalised approaches. Information on vascular access in pregnant women is scant. Different approaches may be considered between women on dialysis already on a well-functioning tunnelled catheter and newly placed catheters: while a tunnelled catheter in a woman already stabilised on outpatient dialysis, who has shown being able to take correct care of it and who has freely chosen this option, is a reasonable choice, central venous catheters placed during pregnancy, especially in the hospital setting, may have a high risk of complications. Conversely, pregnancy may increase the risk of development of fistula aneurysms, but the frequency of this complication is still unknown. The problem of whether or not shifting pregnant patients on peritoneal dialysis to daily haemodialysis sessions is still open, as well as the role of patients’ preference for avoidance of an invasive procedure, or refuse of pain. In the wait for answers, reflecting on the problems encountered by pregnant women on dialysis should make us reflect on how to improve vascular access management for all our patients

Evolution of Structure and Superconductivity in Ba(Ni1−x_{1-x}Cox_x)2_2As2_2

The effects of Co-substitution on Ba(Ni$_{1-x}$Co$_x$)$_2$As$_2$ ($0\leq x\leq 0.251$) single crystals grown out of Pb flux are investigated via transport, magnetic, and thermodynamic measurements. BaNi$_2$As$_2$ exhibits a first order tetragonal to triclinic structural phase transition at $T_s=137 K$ upon cooling, and enters a superconducting phase below $T_c=0.7 K$. The structural phase transition is sensitive to cobalt content and is suppressed completely by $x\geq0.133$. The superconducting critical temperature, $T_c$, increases continuously with $x$, reaching a maximum of $T_c=2.3 K$ at the structural critical point $x=0.083$ and then decreases monotonically until superconductivity is no longer observable well into the tetragonal phase. In contrast to similar BaNi$_2$As$_2$ substitutional studies, which show an abrupt change in $T_c$ at the triclinic-tetragonal boundary that extends far into the tetragonal phase, Ba(Ni$_{1-x}$Co$_x$)$_2$As$_2$ exhibits a dome-like phase diagram centered around the first-order critical point. Together with an anomalously large heat capacity jump $\Delta C_e/\gamma T\sim 2.2$ at optimal doping, the smooth evolution of $T_c$ in the Ba(Ni$_{1-x}$Co$_x$)$_2$As$_2$ system suggests a mechanism for pairing enhancement other than phonon softening.Comment: 7 pages, 8 figure

[MeNC5H5]2[TCNE]2 (TCNE = tetracyanoethylene). Single crystal X-ray and neutron diffraction characterization of an exceptionally long 2.8 Å C-C bond

Journal ArticleThe reaction of N-methylpyridinium iodide, Mepy+I-, and tetracyanoethylene (TCNE) forms [Mepy]2[TCNE]2, which possesses [TCNE]2 2' with an intradimer C-C bond distance of 2.806(1)Å at 50 K from X-ray diffraction, and 2.801(4)Å at 50 K from neutron diffraction. In the IR it exhibits nChN absorptions at 2191, 2174, 2169, 2163 and a nCC absorption at 1366 cm-1, with UV/Vis absorption bands at 26,880 and 18,520 cm-1. Analysis of the cation-hydrogen to [TCNE]2 2- interactions do not provide evidence that the cation stabilizes formation of the [TCNE]2 2- dimer, which is stabilized by the intradimer 2e--4 center C-C bonding interaction

Individual and contextual factors associated with school staff responses to homophobic bullying

This cross-sectional research investigates the individual (i.e., sexual prejudice, contact with lesbian and gay [LG] people, and perceived seriousness of homophobic epithets) and contextual (i.e., homophobic bullying observed by school staff and perceived colleague reactions to homophobic bullying) factors as predictors of school staff intervention against vs. legitimization of homophobic bullying. Data were collected in secondary schools in the North of Italy via a paper-and-pencil survey. Participants were school staff members (N = 273) from 24 Italian secondary schools. The results have indicated that the higher the sexual prejudice and the lower the contact with LG individuals, the higher the legitimization of homophobic bullying. Also, perceiving colleagues as legitimizing or intervening in cases of homophobic bullying predicted similar reactions on the part of school staff participants. The findings are discussed with respect to the current literature regarding homophobic bullying, and applied interventions for school staff training programs to tackle homophobic bullying at school are put forward.info:eu-repo/semantics/acceptedVersio